| Doctor Name: | JULIE PARK |
| NPI Number: | 1245672922 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 2202006992 |
| Business Practice Address: | 5980 Radio Station Rd La Plata, MD - 206463337 |
| Business Phone Number: | 3019326610 |
| Business Fax Number: | |
| Mailing Address: | 6208 Rose Hill Dr, Apt 1b ALEXANDRIA |
| State: | VA |
| Postal Code: | 223106208 |
| Phone Number: | 9736186301 |
| Fax Number: | |
| NPI Enumeration Date: | 07/23/2013 |
| NPI Last Update Date: | 08/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2202006992 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |